For predialysis patients with CKD, those with high BMI variability have an increased risk for adverse outcomes, including mortality, according to a study published in the Journal of the American Society of Nephrology. Researchers conducted a retrospective observational study based on the national health screening database to examine the association between BMI or metabolic parameter variability and the prognosis of CKD. Data were included for 84,636 predialysis patients with CKD. Higher BMI variability was associated significantly with higher risks for all-cause mortality, kidney replacement therapy, myocardial infarction, and stroke (HRs for highest vs lowest quartile: 1.662, 1.201, 1.191, and 1.189, respectively). In subgroups divided according to positive/negative trends in BMI during the exposure assessment period, the results were similar. Variabilities in certain metabolic syndrome components were significantly associated with the prognosis of predialysis patients with CKD; worse prognosis was seen for those with a higher number of metabolic syndrome components with high variability.

Metabolic Syndrome May Worsen Outcomes in CKD

Metabolic syndrome may increase the risk for all-cause mortality and cardiovascular events in patients with moderate CKD, according to a study published in the Journal of Internal Medicine. Investigators examined the association of metabolic syndrome and its components (increased waist circumference, glucose, triglycerides, hypertension, and decreased HDL cholesterol) with all-cause mortality and cardiovascular outcomes in 5,110 patients with CKD. They found that nearly two-thirds of participants (64.3%) had metabolic syndrome at baseline. During 6.5 years of follow-up, patients with metabolic syndrome had a higher risk for all-cause mortality (HR, 1.26) and cardiovascular events (HR, 1.48). The risk increased with a higher number of metabolic syndrome components (HR per component, 1.09 for all-cause mortality and 1.23 for cardiovascular events). For individual components of metabolic syndrome, the glucose component led to the highest increase in risk for all-cause mortality (HR, 1.68) and cardiovascular events (HR, 1.81). “Although our study uncovered a shockingly high frequency of metabolic syndrome in this high-risk patient group, there’s a motivating message for our patients: Each metabolic syndrome component avoided might considerably decrease the risk for a cardiovascular endpoint or premature death,” a co-author said in a statement.